Korean J Med.  2012 Mar;82(3):367-370.

A Case of Lithium-Induced Nephrogenic Diabetes Insipidus and Rhabdomyolysis

• Moh I
• Lee YK
• Son SY
• Sin YH
• Lee SM
• Lee DH
• Noh JW

Abstract

A 59-year-old woman was admitted to our hospital with polydipsia and general weakness. She had a 30-year history of bipolar disorder and was being treated with risperidone (4 mg/day) and lithium carbonate (1,200 mg/day). During her time in hospital, her urine output and serum osmolality increased, and her urine osmolality decreased. She was found to have myoglobulinuria, an elevated creatine kinase level, and abnormal renal function. Based on these findings, the patient was diagnosed with diabetes insipidus and rhabdomyolysis secondary to lithium therapy. After fluid therapy and the withdrawal of lithium, her clinical symptoms improved significantly. Her urine volume decreased gradually after treatment with amiloride. The effects of lithium on the muscle system are unknown. Hyperosmolarity caused by lithium-induced diabetes insipidus is considered a contributing factor in rhabdomyolysis.

Keyword

Lithium; Rhabdomyolysis; Nephrogenic diabetes insipidus

MeSH Terms

Amiloride
Bipolar Disorder
Creatine Kinase
Diabetes Insipidus
Diabetes Insipidus, Nephrogenic
Female
Fluid Therapy
Humans
Lithium
Lithium Carbonate
Middle Aged
Muscles
Osmolar Concentration
Polydipsia
Rhabdomyolysis
Risperidone
Amiloride
Creatine Kinase
Lithium
Lithium Carbonate
Risperidone